Department of Economics, Tufts University, Medford, MA, United States.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Econ Hum Biol. 2020 Aug;38:100870. doi: 10.1016/j.ehb.2020.100870. Epub 2020 Apr 28.
We provide new evidence that weight-related outcomes improved for the severely obese following three recent health insurance expansions. Using Behavioral Risk Factor Surveillance System (BRFSS) data from 2001 through 2016, we examine the effects of Massachusetts health care reform, the Affordable Care Act (ACA) dependent coverage mandate, and the ACA Medicaid expansion on Body Mass Index (BMI) and the likelihood of obesity or severe obesity. Estimates from unconditional quantile regression show that Body Mass Index (BMI) fell among the severely obese who are at the top of the distribution of BMI following all three of these insurance expansions. We also observe a robust reduction in the likelihood of severe obesity following the ACA dependent coverage mandate, and suggestive evidence of a reduction in severe obesity following Massachusetts health care reform. Together, these results identify an important benefit arising from recent health insurance expansions: improved weight-related outcomes for those with severe obesity.
我们提供了新的证据，表明在最近三次健康保险扩张后，严重肥胖者的体重相关结果有所改善。我们使用了 2001 年至 2016 年的行为风险因素监测系统（BRFSS）数据，研究了马萨诸塞州医疗改革、平价医疗法案（ACA）受保人强制参保规定，以及 ACA 医疗补助扩大计划对体重指数（BMI）和肥胖或严重肥胖可能性的影响。无条件分位数回归的估计结果表明，在这三次保险扩张之后，处于 BMI 分布顶端的严重肥胖者的 BMI 有所下降。我们还观察到，在实施 ACA 受保人强制参保规定后，严重肥胖的可能性显著降低，而在马萨诸塞州医疗改革后，严重肥胖的可能性则有降低的迹象。总的来说，这些结果表明，最近的健康保险扩张带来了一个重要的好处：严重肥胖者的体重相关结果得到了改善。
